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South Dakota rates for HCPCS 50389

Rmvl Nfros Tube Req Fluoro Guidance

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.07 / $427.14 / $427.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.93 / $330.76 / $536.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.87 / $146.08 / $1,165.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.23 / $522.70 / $933.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.88 / $759.96 / $3,009.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.33 / $641.19 / $1,002.30
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.00 / $597.44 / $1,002.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.88 / $482.77 / $763.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,643.00 / $1,643.00 / $1,643.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.14 / $690.75 / $1,074.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.40 / $124.10 / $926.50